Young Infants Clinical Signs Study: Developing Tools for Community Health Workers to Save Infant Lives

Project Description

Most deliveries in developing countries occur in the home, assisted by traditional birth attendants or family members. If a newborn appears sick, she or he is generally brought to a rudimentary health care facility near the home, as the nearest hospital may be many miles away. Local facilities are often run by community health workers (CHWs) who have scant training compared to physicians and nurses. Since these health workers are the first line of contact for ill newborns, the ability to recognize early signs of severe illness is critical to improving infant survival. The goal of the Young Infants Clinical Signs Study was to devise a set of simple guidelines to allow community health workers to identify symptoms or signs of illness that indicate when a sick newborn (0 to 6 days old) or a young infant (aged 7 to 59 days) should be referred to a hospital for care.

The study identified seven predictors of the need to refer a sick infant from a community facility to a hospital. They are: 1) difficulty feeding, 2) convulsions, 3) movement only when stimulated, 4) high respiratory rate, 5) severe chest indrawing, 6) fever (≥ 37.5oC), and 7) below-normal body temperature (< 35.5oC). These signs and symptoms, relatively easy to identify by health care personnel at the community level, work not only for newborns in their first week of life but also for infants 7 to 59 days old. Applied widely, this simple checklist should have a major impact on neonatal mortality, provided that families seek care for the newborn within the formal health sector when referred. This simple set of clinical predictors has been used to update the World Health Organization’s Integrated Management of Childhood Illness (IMCI) algorithm for infants less than 2 months old. Country-specific variations of this algorithm have been approved and implemented in India.

This project is one activity of the CGHD’s Child and Family Applied Research project (CFAR).

Project Details

Principal Investigator Davidson Hamer
Boston University Co-Investigators Kojo Yeboah-Antwi
  • Emmanuel Addo-Yobo, Komfe Anokye Hospital, Kumasi, Ghana
  • John Carlin, University of Melbourne
  • Gary Darmstadt, John Sno, Inc.
  • Prakash Jeena, University of Kwazulu Natal
  • Martin Weber, World Health Organization
Country(ies) Bangladesh, Bolivia, Ghana, India, Pakistan, South Africa
Dates of Research 2001–2007
Donor/Funder USAID logo United States Agency for International Development (USAID)